Relationship between social environmental factors and use of medical services among the Japanese elderly

Background: Japan faces the challenges in sustaining the national medical insurance system. It gets even more serious due to the rapidly aging population. While we need drastic changes of the medical systems for the complete solution and the discussion is being on progress, in 2009, the insurance system installed a particular component for the people aged 75 or older to resolve the system’s distortion. It has been five years since its implementation and the data were accumulated. Although useful, those data for medical usages among the people have not been utilized well enough to develop public health strategies.

Methods: This study used the medical usage data of Japanese aged 75 or older to assess the relationship of the social environmental variables at the level of municipalities of a prefecture, using the steptwise regression analysis. Analyses were done separately for in-patients and out-patients as well as gender.

Results: Analyses on the he data including 47 municipalities showed that household ownership rate of cars, marriage rate, employment rate, college-going rate, and health care costs among the younger were related to male’s in-patients, while municipal’s financial capability index was to female’s. Manufacturing rate and retail stores per capita were related to for male’s out-patients, while average income and house ownership were to female’s.

Conclusions: Although we need to be careful with ecological fallacy in looking at the data that this study used, having wider perspectives on what people’s lives are and such data provides useful insights in strategizing the public medical system.